腹腔镜联合腹部小切口根治性肾输尿管切除术(附17例报告)

Radical nephroureterectomy with laparoscopic and small abdominal incision (reports of 17 cases)

目的探讨腹腔镜联合腹部小切口根治性肾输尿管切除术治疗肾盂输尿管癌的临床应用价值。方法施行17例腹腔镜联合腹部小切口根治性肾输尿管切除术,其中肾盂癌13例、输尿管癌4例;病灶位于左侧10例、右侧7例。结果 17例全部成功,无中转开放手术的患者。手术时间85～160 min,平均(110.26±20.35)min。术中出血量约50～220 mL,平均(142.32±70.26)mL。术中及术后无严重并发症。术后随访11～38个月,未见肿瘤种植转移及膀胱肿瘤发生。结论腹腔镜联合腹部小切口根治性肾输尿管切除术,具有微创、术后恢复快等优势,将成为治疗上尿路移行细胞癌较理想的手术方法。

Objective To explore the clinical value of laparoscopy combined with miner abdominal incision radical nephroureterectomy for carcinoma of renal pelvis and ureter. Methods Seventeen patients were performed transperitoneal laparoscopic nephrouretereetomy,ineluding renal pelvic carcinoma 13 cases and ureter carcinoma 4 cases. Results Laparoscopic procedures were completed in all the cases.The mean （range） operating time was （l10.26±20.35）minntes （85～160 minutes）; mean （range） blood loss was （142.32±70.26）ml （50～220 ml）. There was no intraoperative or postoperative complication in all cases. No case of local or systemic relapse and new tumor of the bladder were observed by follow-up of 11 to 38 months. Conclusions Laparoscopic and miner abdominal incision nephroureterectomy is feasible and effective, It becomes an ideal surgical technique for transitional cell carcinoma of upper urinary tract.